Acute sixth nerve palsy in a young man, beware of the 'red herring'.
BACKGROUND
Cranial nerve palsies has several etiologies including vascular insufficiency, neoplasm, trauma and inflammation. Isolated sixth nerve palsy is an extremely rare presenting feature of leukemia.


OBJECTIVE
We describe an unusual ocular presentation of a bilateral progressive sixth nerve palsy in a young male with a preceding head injury.


CONCLUSIONS
Acquired sixth nerve palsies in young adults may be due to trauma but in the absence of a definitive history other systemic processes must be outruled. We describe a case of bilateral sixth nerve palsy in a patient with ALL with no obvious CNS involvement. Potential etiological mechanisms are discussed.
O'Neill
E C
EC
Ophthalmology Department, Waterford Regional Hospital, Waterford, Ireland. evelynoneill@yahoo.com
Connell
P P
PP
Kadare
S
S
Tormey
P T
PT
D020434:Abducens Nerve Diseases / Q000175:diagnosis* / Q000473:pathology; D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000188:drug therapy; D013479:Superior Vena Cava Syndrome; D015357:Vision Disparity
D000970:Antineoplastic Agents